It takes only one such expense to make a pet owner wonder: Should I have pet health insurance?

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On the one hand,Sheryl routine veterinary care has been in a down-stay. According to the American Veterinary Medical Association, routine visits to the vet were down 1.7 percent between 2006 and 2011.

But serious illness or accidents are another thing, says Dr. Christine Hardy of Colorado State University’s Flint Animal Cancer Center.

“People have a high expectation for treatment of pets,” Hardy said. “They might put off periodic visits, But if there is an emergency — a fight with another dog, getting hit by a car — they’llspend the money.”

It hasn’t taken long for American business interests to recognize a golden opportunity. The first pet insurance company in the U.S., Veterinary Pet Insurance, or VPI, was founded in 1982. Today, there are at least a dozen pet insurance companies serving the United States.

But is a policy worth buying? The answer, depending on who you talk to, is yes, no and maybe.

Colorado pet owners have mixed feelings.

Holly Kylberg, owner of Clocktower Events in the D&F Tower in downtown Denver, is a fan.

“I do think insurance protection is good.” Kylberg said. “My Belgian sheepdog Kona was playing in the yard and cut his foot. It cost $500 to treat. I am going to get pet insurance now. I have one girlfriend whose dog had a broken hip and it cost $18,000.”

But Felicia Diamond, a nonprofit consultant in Denver, is reluctant to buy for a reason that gets frequent mention. “There seems to be so many exclusions,” she said.

The experts aren’t in consensus, either. At one extreme is Dr. Robin Downing, founder of the Downing Center for Animal Pain Management in Windsor. She is one of the country’s leading proponents of providing palliative care to animals at the end stages of life.

“Pet insurance is not simply worthwhile, it is becomingessential,” Downing said. “Veterinary medicine continues to become more spohisitcated, and that means the costs continue to rise ... It is truly impossible for a pet owner to ‘self-insure’ by, say, putting money into a savings account.”

Downing was alluding to a September 2011 article in Consumer Reports questioning the wisdom of pet health insurance.

Consumer Reports compared three companies that controlled 90 percent of the market (ASPCA Pet Health Insurance, 24PetWatch QuickCare, and VPI). The magazine concluded that pet insurance generally cost more than it paid out. Only in uncommon cases, when a pet required very expensive care, did coverage more than pay for itself.

“We believe most pet owners will be better off passing up pet insurance and instead putting some money into an emergency kitty,” wrote the author, Tobie Stanger.

Critics of the report say pet owners are unlikely to do that.

“Americans don’t save well,” said Curtis Steinhof, marketing director for VPI, the biggest U.S. company. “You can put aside $30 a month for two months, and if there’s a problem you’d have just $60. Or you could have invested it in two months of premiums with a $14,000 care limit.”

Author Steiger stands firm. “The pet insurance industry banks on people acting irresponsibly,” she said recently. “And it banks on people humanizing their pets. One of their promotional brochures even calls animals ‘fur-babies.’“

Then there are those who bought the product and wish they hadn’t. Their complaints are detailed in Better Business Bureau records. Most BBB complaints have to do with “products/service,” such as disagreement about what does or does not constitute a pre-existing condition. There are also a number of complaints about billing and advertising.

In most cases, the BBB found that the companies had made a good-faith effort to deal with the complaints. The underlying message of the companies’ responses seems to be: You should have read the policy or listened to the sales agent more closely.

Regardless of the questions, the pet insurance industry is logging steady growth. In 1998, 1 percent of dogs and no cats were covered, according to the American Pet Products Association. In 2010, 4 percent of dogs and 1 percent of cats were covered.

Pat Smith, an executive with a Denver nonprofit organization, is one of the converts.

She calls pet insurance “an excellent financial management tool. Knowing I had a very rambunctious yellow Lab and that an injury was possible, it was a lot cheaper to pay $300 a year (for insurance) than $5,000 for tendon/leg repair.”

Pondering pet health insurance? Read these tips first

What is Pet health insurance?

Pet health insurance is basically property insurance, since pets are still viewed by law as property. There usually are co-pays and deductibles. The higher the deductible, the lower the premium. Premiums increase with an animal’s age, so it pays to enroll animals when they are younger.

Some companies cover routine wellness care, including vaccines, while others insure solely for illness and emergencies. There are varying guidelines on amounts reimbursed and maximum payouts per claim. Some companies have riders for special coverage, such as cancer. Some refuse to cover illnesses that may be deemed congenital or developmental, such as hip dysplasia. None offer reimbursement for pre-existing conditions, nor preventable conditions like periodontal disease.

In some cases, insurance providers will not insure a specific pet or breed of pet, or may limit the number of pets you can insure, if they consider them “high-risk.” Some give multiple pet discounts.

Using a website called petinsurancereview.com, we asked for insurance quotes for a basic plan for a 7-year-old Labrador retriever with a history of two anterior cruciate ligament surgeries on its rear legs. Four companies responded.

Trupanion, based in Seattle: $56.19 a month.

VPI, based in Brea, Calif.: $35.94 a month.

Pets Best, based in Boise, Idaho: $46.03 a month.

Petplan, based in Philadelphia: $114.03 a month.

So far, so good. But here’s where it gets tricky. All the companies offered different deductibles and maximum payouts. They had riders (add-ons) for all sorts of things, such as wellness plans, hip dysplasia, third-party damage and cremation or burial costs. Then, a pet owner must carefully read the policy to learn about exclusions (such as the cruciate tears), the effective date of the policy and so on.

The bottom line: Just like with human plans, the one with the cheapest premium may not be the best for your pet.

How to check out a pet health policy

Read it carefully. Ask the sales rep plenty of questions. Compare several carriers.

Talk to your veterinarian. Robin Downing, for example, says employees at her clinic comb through the offerings and “help our clients by recommending the two companies that offer the very best coverage for the dollar at the moment — Pets Best Insurance and PurinaCare Pet Insurance.”

Jeffrey Steen of Alameda East Veterinary Hospital in Denver tells clients to be sure to research the various options. He also tells them about the Consumer Reports article on the option of saving accounts.

Check with the Better Business Bureauto read about the companies online, including complaints and how the companies have dealt with them.

Complaints can also be filed with the Colorado Division of Insurance, dora.state.co.us/insurance/ Spokesman Vince Plymer said the agency has dealt with 33 complaints in the past 10 years.

The American Veterinary Medical Association has online guidelines for pet insurance: avma.org.

Downing and VPI’s Steinhof suggest looking for a company that has been in business for a while.